Accounts Payable Contact Information

Contact Name:

Contact Email:

Phone Number:

Tax Exempt Status

Charge me sales tax:
If you do not check this box, you must provide a copy of your Tax Exemption Certificate

Type of Business:

Credit References

If your company has been in business for less than three years, please provide a minimum of three references.Please do not use VWR, Fisher Scientific or Sigma-Aldrich as they do not supply credit data.